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| STATE OF ILLINOIS~— 


Board of Administration.| 


| RULES AND REGULATIONS 
| th Revised June 1, 1913, 
: 


for the government of the 


: Zigrin State Hospital, 

Kankakee State Hospital, 

Jacksonville State Hospital, 

- Anna State Hospital, 

| Watertown State Hospital, 

|. Peoria State Hospital, 

Chester State Hospital, 
Chicago State Hospital, 

Alton State Hospital, 
Psychopathic Institute, 
Lincoln State School and Colony, } 


OFFICE OF THE BOARD 
State Capitol, Springfield. 


STATE OF ILLINOIS 


Board of Administration. 


RULES AND REGULATIONS 


Revised June 1, 1913, 


for the government of the 


Elgin State Hospital, 
Kankakee State Hospital, 
Jacksonville State Hospital, 
Anna State Hospital, 
Watertown State Hospital, 
Peoria State Hospital, 
Chester State Hospital, 
Chicago State Hospital, 
Alton State Hospital, 
Psychopathic Institute, 
Lincoln State School and Colony, 


Under the control of the Board of Administration. 


OFFICE OF THE BOARD 
State Capitol, Springfield. 


SPRINGFIELD: 
ILLINOIS STATE JOURNAL CO., STATE PRINTERS 
1913 


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WEPART Mcwy 


STATE OF ILLINOIS 
BOARD OF ADMINISTRATION. 


———— 


FRED J. KERN, President. 
B. R. Burroucus, Secretary. 
FRANK D. Wuirep, Fiscal Supervisor. 
FRANK P. Norpury, M. D., Alienist. 


KJ THomaAs O’ConNorR. 
aay 
9 
eT Kankakee State Hospital, Hospital, Illinois. 


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' Elgin State Hospital, Elgin, Illinois. 
.>dacKsonville State Hospital, Jacksonville, Illinois. 
Anna State Hospital, Anna, Illinois. 

Watertown State Hospital, Watertown, Illinois. 
Peoria State Hospital, Peoria, Illinois. 
Chester State Hospital, Menard, Illinois. 
ie y Chicago State Hospital, Dunning, Illinois. 
Alton State Hospital, Alton, Illinois. 
Psychopathic Institute, Kankakee, Illinois. 


at Lincoln State School and Colony, Lincoln, Illinois. 


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in 2022 with funding from 
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https //archive.org/details/rulesregulationsOOilli_6 


RULES AND REGULATIONS. 
(Revised June 1, 1913.) 


The activities of these institutions shall be divided 
into the following departments: 

The Medical Service. 

The Nursing Service. 

The Business Administration. 

The Mechanical Department. 

The Farm. 

The Garden. 


Tue MEDICAL SERVICE. 


The Medical Service shall consist of the superin- 
tendent, the assistant superintendent, physicians, 
assistant physicians, medical internes, dentist, dental 
interne, pharmacists, stenographers for the medical 
service, and clinical clerk. 


THE NURSING SERVICE. 


The Nursing Service shall consist of a chief nurse, 
supervising nurses, charge nurses, nurses, pupil 
nurses, attendants and hydrotherapist. 


Tue BUSINESS ADMINISTRATION. 


The Business Administration shall consist of the 
following divisions: 

The Accounting Department. 

The. Store. 

The Industrial Service. 

The Domestic Service. 

The Culinary Service. 

The Driving Department. 

The Accounting Department shall consist of a 
chief clerk and necessary assistants. 

The Store shall consist of a storekeeper and neces- 
sary assistants. 


The Industrial Service shall consist of an indus- 
trial teacher, a shop foreman, and necessary assist- 
ants for each. 

. The Domestic Service shall consist of a head house- 
keeper, a head laundryman and a head seamstress, 
and necessary assistants for each. 

The Culinary Department shall consist of a dieti- 
tian, a pasteurizer, head cooks, cooks and necessary 
assistants. : 

The Driving Department shall consist of a coach- 
man. 


THE MECHANICAL DEPARTMENT. 


The Mechanical Department shall consist of the 
following: A chief engineer, assistant engineer, 
engineers, boiler maker, steamfitter, plumber, elec- 
trician, firemen, engineer’s helpers, a head mason, 
masons, plasterers, laborers, a head carpenter, car- 
penters, a head painter, painters, a blacksmith and 
a tinner. 


THE FARM DEPARTMENT. 


The Farm Department shall consist of a head 
farmer, a dairyman, a poultryman and necessary 
assistants for each. 


THE GARDEN DEPARTMENT. 


The Garden Department shall consist of a head 
gardener, a florist and necessary assistants for each. 


THE SUPERINTENDENT. 


The superintendent shall be the chief medical and 
executive officer of the institution, and, subject to 
the Board of Administration, shall exercise entire 
official control over the subordinate officers and 
employees in the service. He shall have the general 
superintendence of the buildings, grounds, farm and 
garden, together with all stock, machinery, furniture, 
fixtures and equipment of every nature belonging 
to the institution. 

It shall. be his special duty to see that all officers 
and employees are energetic, punctual and exact in 


_ 


the faithful performance of their several duties. He 
shall have entire control of the medical, moral and 
dietetic treatment of the patients. It shall be his 
duty to visit the wards sufficiently often fully to 
inform himself as to their condition and to assure 
himself that his directions concerning the care and 
treatment of the patients are being faithfully 
executed. He shall cause to be made, in the manner 
prescribed by the Board of Administration, a full 
and complete history of the admission, examination, 
classification and treatment of each patient com- 
mitted to the institution. It shall be his duty to 
see each newly admitted case within five days follow- 
ing admission and to have note of such visit entered 
in the staff meeting record and in the clinical record 
of the patient. He shall be charged with the respon- 
sibility of determining when patients are sufficiently 
recovered to warrant their parole or discharge. He 
shall have power to parole and to extend the parole 
of patients from time to time as may be provided 
for by law or by rule of the Board of Administration, 
and to discharge patients when in his judgment their 
condition warrants such discharge. 

The superintendent is charged with the carrying 
on of all correspondence of every nature concerning 
the institution’s administration and pertaining to 
patients, and it shall be his duty to delegate such 
portions of this correspondence to the assistant super- 
intendent, members of the medical staff and chief 
elerk as in his judgment will best serve the interests 
of promptness, thoroughness and unfailing courtesy. 
It shall be his duty to require subordinates who 
assume any portion of the ccrrespondence, to answer 
fully and promptly every inquiry, and to have the 
letters in answer to inquiries concerning patients 
couched in the most courteous and respectful lan- 
. guage. The official correspondence of the institution 

shall be written upon the letter-head of the institu- 
tion, form of which shall be furnished by the Board 
of Administration, and shall, as far as possible, be 
signed in person by the superintendent. When 
authority to sign his name to letters is delegated to 
a subordinate officer, such letters shall be submitted 
to him for his personal inspection before they are 
mailed. 


— 


He shall have charge of the inmates’ trust fund; 
shall accept deposits, giving his receipt therefor; and 
shall disburse the funds thus deposited in the man- 
ner and for the purpose requested by the friend or 
relative of the patient who makes such deposit, pro- 
vided such disbursements shall not be made for any 
purpose prejudicial to the best interests of the 
patient or that does not have his full approval. He 
shall cause to be kept a set of books in the manner 
and form prescribed by the Board of Administration 
that will readily show such receipts and disburse- 
ments, with the balance on hand at the close of any 
day’s business. 

It shall be the duty of the superintendent to co- 
Operate with the State Psychopathic Institute in the 
matter of instruction of the members of the medical 
staff, of case examinations and of case record keep- 
ing, to whatever extent is required by the Psycho- 
pathic Institute and approved by the Board of Ad- 
ministration. 

It shall be his duty to conduct a school of instruc- 
tion for attendants and a training school for nurses 
in the manner and form prescribed by the Board of 
Administration. 

He shall be charged with the duty of a full and 
complete inspection of the accounting department, 
the store, the laundry, the sewing room, the shops, 
the kitchens, the mechanical department, the farm 
and garden, and their equipment, and to confer with, 
advise and direct the heads of all departments of the 
institution in carrying out the directions of the 
Board of Administration and the institution policies. 

All of the property of the institution being under 
the direct care and custody of the superintendent, 
‘it shall be his duty to arrange in such manner as 
may be prescribed by the Board of Administration 
for the interchange of farm, garden and industrial , 
products with other institutions. When, in the judg- 
ment of the superintendent, it becomes advisable to 
sell any live stock, produce, condemned implements, 
or any of the property or equipment belonging to 
the institution, he shali make written application to 
the Board of Administration for permission to make 
such sale, and upon their approval, shall sell in such 
manner as may be prescribed by the board. When 


the consummation of such sale is delegated to the 
head of any department, the superintendent shall 
issue to such person a written permit to make the 
sale, giving full description of whatever is to be 
sold. After the sale has been completed, the person 
authorized to make the same shall endorse upon the 
back of the superintendent’s permit the date of sale, 
full name and address of the purchaser, items sold 
with price obtained, and his own signature, and 
shall file the permit so endorsed with the chief clerk, 
together with the funds received in settlement. 


It shall be the duty of the superintendent to have 
prepared at the close of each day’s business, a de- 
tailed report of movement of population, and trans- 
mit same to the Board of Administration, as 
provided for by the rules of the board, and to include 
therewith carbon copies of all requisitions for sup- 
plies issued by the storekeeper during the day’s 
business; also carbon copies of all orders for sup- 
plies, and carbon copy of any general or special 
order which he may have issued during the day. 

To facilitate uniformity in, making up the daily 
report, the following order in reporting events will 
be observed (General Order No. 62): 

Report of Unusual EHvents— 

1. Accidents to the plant. 

2. Accidents to employees. 

3. Presence of epidemic disease, 

(Name the disease and number of cases.) 
Movement of Population; Admissions; Discharges— 


1. By parole. 

2. By escape. 

3. By death. 

4.» By court order. 

5. By order of the Board of Administration. 
6. By the superintendent. 

7. By any other form of discharge. 


Seclusion and restraint in accordance with special 
orders No. 170. 
Seclusion; Seclusion and Restraint; Restraint— 


Pa90'p 


10 


Movement of Officers— 

1. Managing officer, present or absent. 

2. Assistant superintendent, present or absent. 

3. Other officers absent from duty. 

4, Other officers on sick leave. 

Note—When present, managing officers must per- 
sonally sign the daily reports in ink. 

When these rules and regulations become effective, 
it shall be the duty of the superintendent to place 
in the hands of every employee then in the service, 
or who. shall enter the service thereafter, and take 
receipt therefor, copy of a booklet which shall be 
provided by the Board of Administration for the 
guidance and direction of employees in their con- 
duct and in their relations toward patients and to 
require all employees to follow strictly the rules 
therein set forth. 

Being charged with the general supervision of all 
of the employees, it shall be the duty of the superin- 
tendent to require each and every employee to give 
all of his time to the service of the institution, and 
he shall forbid and prevent employees from engaging 
in work of any naturé for private purposes. 

It shall be the special duty of the superintendent 
to see that each and every person who visits the 
institution for any purpose shall promptly receive 
the attention, courtesy and consideration that is his 
due from each and every employee with whom such 
visitor has to do; and so to conduct the institution 
and its affairs that all branches of its activities 
where they come in contact with its patrons and 
the general public shall be such as will in every way 
commend the institution to the public. 


Tne ASSISTANT SUPERINTENDENT. 


The assistant superintendent shall be the second 
ranking officer of the institution, and shall be, as 
his title indicates, an assistant to the superintendent 
in carrying out the details of the administration. 
During the temporary absence or illness of the super- 
intendent, he shall succeed to the active manage- 
ment and have all the rights and powers of the 
superintendent. His engagement is for service prac- 
tically continuous, and he shall be on active duty 


& 


11 


from 8:00 a. m. to 6:00 p. m. of each day. Subject 
to the approval of the superintendent, he shall have 
entire charge of the medical service. It shall be 
his duty to divide the service into suitable assign- 
ments for the various members of the medical staff, 
taking into account that recently admitted patients 
and those in the infirmaries and hospital wards re- 
quire a larger degree of attention, and the number 
of patients assigned to the various members of the 
medical staff shall be in suitable proportion to the 
requirements of the patients. Assignments in the 
various departments of the medical service of the 
institution may be changed from time to time at the 
discretion of the assistant superintendent with the 
approval of the superintendent. 

Subject to the approval of the superintendent, he 
shall regularly detail the stenographers in the med- 
ical service to their duties, having in view that the 
correspondence shall be promptly answered and that 
case examinations and case record keeping shall 
always be kept up to date. He is charged with the 
inspection and direction of the entire system of 
records pertaining to patients, and it shall be his 
duty to require the clinical clerk to keep these rec- 
ords in such manner and form as may be prescribed 
by the superintendent. He shall have immediate 
charge of all drugs, medicines, medical and surgical 
supplies, and shall aid and direct the pharmacist in 
the execution of the duties of that position. It shall 
be his special duty closely to supervise the issuing of 
alcoholic liquors from the pharmacy and to see that 
none are used for purposes other than those of a 
medical agent. 

He shall receive all patients who are admitted 
to the institutions and shall have direct charge of 
all the official records concerning the admission, de- 
tention, death or discharge of patients; and it shall 
be his duty to see that these entries are properly 
and promptly made and that each day’s business is 
completely entered at the close of the day. In 
receiving female patients from officers or other per- 
sons, he shall see that the requirements of the law 
for the proper attendance of female patients are 
carried out in every instance. It shall be his duty 
to report immediately to the superintendent every 


12 


case of accident, injury or serious illness of patients 
that comes to his attention. Illness of officers or 
employees which renders them unfit for duty shall 
be promptly reported by him to the superintendent. 

He shall visit the hospital wards or buildings for 
the physically sick at least once in each twenty-four 
hours and shall make such other visits to all of the 
wards of the institution as time will allow to famil- 
iarize himself with the condition of each patient and 
to know personally, as far as possible, all of the 
patients of the institution. 

He shall have immediate charge of the school of 
instruction for attendants and of the training school 
for nurses, and, under the direction of the superin- 
tendent, shall carry out all of the plans for this 
branch of the service, and shall require that proper 
records of attendance and class work be faithfully 
kept. 

His relation to the management is of such a 
nature that he should at all times keep in touch 
with the policies of the administration and use his 
best efforts to carry them out, and to this end, in so 
far as his other duties allow, he shall, by personal 
inspection, endeavor to familiarize himself with the 
condition of the physical property, the mechanical 
equipment, the farm and gardens, and all of the 
activities of the institution, that he may be better 
enabled to administer the affairs during any tem- 
porary absence of the superintendent. 


PHYSICIANS. 


All physicians shall have equal rank in the service 
and shall be charged with the responsibility for the 
immediate care of the patients assigned to them 
from time to time by the assistant superintendent 
under the approval of the superintendent, and for 
the carrying out in detail of all of the policies of the 
superintendent or his assistant, together with their 
special directions for the care and treatment of 
patients in the application of all remedial agents in 
use by the medical service of the institution. Their 
engagement is for a service practically continuous, 
and they shall be required to be on active duty from 
8:00 a. m. to 5:00 p. m. of each day and shall be 
subject to call whenever their services may be re- 
quired at any other hour of the day or night. 


— 


af ~~ 


13 


It shall be their duty to visit each ward assigned 
to their care at least twice during the day and to 
spend -in the wards under their immediate control 
as many of the remaining hours of active duty as 
may be taken from the other duties of their position. 
The visitation of wards is to be of such a degree of 
thoroughness as will enable the physician to know 
at all times that he has accurate knowledge concern- 
ing the mental state and physical condition of every 
patient under his care. Whenever it becomes neces- 
sary to administer to any patient food or medicine 
coercively, it shall be done only at the specific direc- 
tion of the medical officer in charge, and then only 
in his immediate presence. In addition to the visi- 
tation to patients, it is required that they shall give 
constant attention to the cleanliness, order and 
ventilation of the wards under their care, and they 
shall require the charge nurses to report promptly 
to the proper department needed repairs of any 
nature. <A frequent visitation to dining rooms dur- 
ing the serving of meals and an inspection of the 
food served, both as to quantity and quality, together 
with the thoroughness of its preparation and the 
character of the dining room service, shall be a spe- 
cial duty of physicians; if the service is found unsat- 
isfactory in any particular, it shall be their duty to 
make report of same by word of mouth to the 
assistant superintendent. 

The relation of this branch of the service is of 
such importance to the general success of the insti- 
tution, that all its members shall diligently apply 
themselves to the obtaining of information as to the 
physical property, the mechanical equipment and 
the general activities and policies of the institution, 
and shall lend their efforts to its support in every 
reasonable way. 


ASSISTANT PHYSICIANS. 


Assistant physicians are to be of a rank one re- 
duced from that of physician, and all persons in this 
service shall be of equal rank. They shall be, as 
their title indicates, assistants to the superintendent, 
assistant superintendent and physicians, and shall 
be assigned to a service in harmony with their pre- 


14 


scribed duties. They shall in all instances carry out 
fully any directions given them by their superior 
officers in the medical service, and, so far as possible, 
contribute constantly to the care, comfort and wel- 
fare of the patients. Their engagement is for 
service and hours of duty similar to those of physi- 
cians. 
MEDICAL INTERNES. 

Medical internes may enter the service in a man- 
ner prescribed by the rules of the Civil Service Com- 
mission, and the period of interneship shall. be 
limited to one year of service, at the expiration of 
which a certificate of service shall be given by the 
Board of Administration, attested by the superin- 
tendent of the institution. Their duties shall be 
prescribed by the superintendent, and their hours 
of service shall be similar to those of physicians and 
assistant physicians. 


DENTIST AND DENTAL INTERNE. 


In accordance with general orders No. 71 and 
under the direction of the managing officer or the 
assistant superintendent, the dentist shall have 
entire charge of the dental work for patients and 
inmates of the institution. It shall be his duty to 
make an examination as to the dental needs of each 
patient or inmate received, within five days after 
admission, and to make report of such examination 
in the form provided for the permanent record in 
the case history or official record. It shall be his 
duty, with the assistance of his interne, if one is pro- 
vided, to faithfully carry out the dental procedures 
necessary for the comfort of the patients with special 
reference to conserving teeth that may be benefited 
by treatment and subsequent repairing. The hours 
of duty for the dentist and interne shall. be from . 
8:00 o’clock a. m. to 5:00 o’clock p. m. week days, 
and they shall be subject to call at any time by the 
managing officer or the assistant superintendent. 

In order to secure uniformity in dental work done 
by dentists at the institutions under the control of 
this board, and charges made for same, the follow- 
ing rules and regulations are hereby published for 
the guidance of all concerned: 

The work to be that usual in the practice of den- 
tistry, consisting of extracting, cleaning and all 


15 


necessary treatments, amalgam and various cement 
fillings of the teeth, and repair of plates. All of 
this work to be given free to all cases, the same 
being service on an equal footing with that of the 
medical service. 

Porcelain crowns (anterior) will be given free to 
patients or inmates on the recommendation of the 
managing officer. . 

In the discretion of the managing officer, plate 
work, etc., may be done, free of cost, to patients or 
inmates who are performing service in the institu- 
tion. A record of this service to be made and filed 
with the case record or official record of the patient 
or inmate. 

Gold work and plate work, in all cases, will be 
charged for extra at the following prices: 


Goldfinger. esas: Eh ih he 1 s,dpia cee ens $1 00 
Gold crowns (incisors and bicuspids)......... 2 25 
CrOLMCLOW NS LOL IMOLAEA By sche caterer cre caren ate 2 50 


Bridge work at corresponding prices. - (Bridge 

work to be recommended only in exceptional 

cases. ) 

PIACGM WOE PeTIeT. WD IELG wat foe te ols cel occ eae muah etece 3 50 
(Excepting where gold clasp is used, when the 

extra cost for the clasp will be charged at 

the rates to be $0.75 to $1.00.) 

In special work recommended by friends of the 
patient or inmate, the prices to be agreed upon as 
near the above prices as practicable. The managing 
officer will notify relatives, conservators or friends 
two weeks in advance of the proposed special work 
needed for the patient or inmate. If no reply is 
made to such recommendation the work will be done 
by the dentist in the same manner and with the 
same material as that given in the ordinary routine 
of service. 

Relatives, conservators or friends of the patient 
or inmate are free to have dental service performed 
outside of the institution, but such work must be 
done at their own expense, and the charges for the 
same are to be regulated by the dentist doing the 
work. 

The income received from all charges for dental 
work shall be paid to the managing officer who will 
receipt for same, and by him transmitted monthly 
as miscellaneous receipts to the State Treasurer. 


16 


No work will be done by the dentist for employees 
excepting in emergencies, for which there will be 
no charge. 

Dentists and internes employed by the month and 
giving full time between 8:00 o’clock a. m. and 5:00 
o’clock p. m. on each week day will not be allowed 
to practice dentistry, excepting for patients or in- 
mates of the institution as herein provided. 

No dentist will be allowed to receive fees or hon- 
oramiums unless same are submitted to the State 
Treasurer. 

Records of the work performed by the dentist 
should be kept properly classified, and a copy of the 
same transmitted monthly, addressed to the Alienist, 
Board of Administration. 


‘DENTIST AND DENTAL INTERNE. 


Classification of work done to be as follows: 
Name of patient and dates of service. 
Number of patients examined. 

Number of teeth extracted. 

Number of teeth cleaned. 

Number of teeth treated. 

Number of roots filled. 

Number of amalgam fillings. 

Number of cement fillings. 

Number of gold fillings. 

Number of crowns, porcelain. 

Number of crowns, gold. 

Number of plates. 

Summary of charges made for service. 
Summary of free service. 

Summary of expenses incurred, special. 
Summary of expenses incurred, quarterly supplies. 


PHARMACIST. 


The pharmacist shall be a regularly licensed phar- 
macist under the laws of the State of Illinois, and in 
institutions where the services is not extensive 
enough to require the services of such pharmacist, 
all prescriptions must be filled by the physician who 
writes them. 

The pharmacist shall be under the immediate 
direction of the assistant superintendent, and shall 


- 


* 


ah 


have charge of all drugs, medicines and medical and 
surgical supplies; and shall promptly fill prescrip- 
tions and issue goods from the department upon 
proper prescrition or requisition. It shall be a spe- 
cial duty-of the pharmacist to keep the assistant 
physician advised of any apparent excess in the issue 
of intoxicating liquors, sedative or narcotic drugs. 
Subject to the approval of the assistant superintend- 
ent, the pharmacist shall prepare estimates for the 
requirements of this department. 

In accordance with General Orders No. 70, all phar- 
macists or officers in charge of the drugs and phar- 
maceuticals in the State charitable institutions under 
the control of the Board of Administration are here- 
by directed not to receive drugs or pharmaceuticals 
which do not conform with the specifications fur- 
nished by the Purchasing Committee of this board. 
No officer of an institution -will be allowed to de- 
termine whether the brands of certain drugs or phar- 
maceuticals, other than those specified, are equal to 
those specified. All such articles will be rejected 
and the firm is to be duly notified, in the name of 
the Purchasing Committee, that the articles are held 
at the institution. subject to its order. 

Copies of specifications may be obtained upon appli- 
cation to the board at Springfield. If the specifica- 
tions in any way appear to be ambiguous to the phar- 
macist or the responsible officer, then he is to obtain 
an interpretation from the Purchasing Committee. 

A copy of this order is to be posted in the drug 
room or wherever the drugs and pharmaceuticals are 
stored. 

The hours of duty shall be from 8:00 a. m. to 5:00 
p. m. week days, but subject to call of the assistant 
superintendent at any time. 


STENOGRAPHER FOR THE MEDICAL SERVICE. 


The stenographers for the medical service shall be 
subject to the detail of the assistant superintendent 
in answering correspondence concerning patients and 
in taking and recording examinations and case his- 
tories of patients. There shall be a sufficient number 
of stenographers provided, and it will be expected 
that the work in this department be kept up and 


18 


finished as nearly as possible to the close of business 
each day. The hours of duty shall be from 8:00 
a. m. to 5:00 p. m. week days. 


CLINICAL CLERK. 


The clinical clerk shall be under the immediate 
direction of the assistant superintendent. The hours 
of duty shall be from 8:00 a. m, to 5:00 p. m. -The 
duties of the position require a full and complete 
entry of every change or movement of patients. He 
shall have charge of all official records concerning 
patients, and shall aid the medical staff and the ste- 
nographers in obtaining necessary information from 
such records. It shall be his further duty to aid in 
the preparation of statistics and other information 
needed from time to time, and for the preparation 
of all reports from this department required by law 
or by rule of the administration. 


THE NURSING SERVICE—UNIFORMS. 


The uniform of the chief nurse shall be of white 
material, to be made in such style as shall be agreed 
upon between the superintendent and the chief nurse. 
She shall wear no cap. 

The uniform for female supervising nurses shall 
be of white material, to be made in such style as shall 
be agreed upon between the superintendent and the 
chief nurse. They shall wear the cap of a graduate 
nurse, as hereinafter described. 

The uniform of the charge nurse of a hospital or 
infirmary shall be of white material, to be made in 
such style as shall be agreed upon between the super- 
intendent and the chief nurse. She shall wear the 
cap of a graduate nurse as hereinafter described. 

The uniform for all graduate nurses, other than 
those above mentioned, shall be of the striped mate- 


rial prescribed by the Board of Administration, to ~ 


be made in such style as shall be agreed upon be- 
tween the superintendent and chief nurse. They shall 
also wear a white apron and bib and the cap of a 
graduate nurse, which shall be a cap of white mate- 
rial and style to be agreed upon between the superin- 


- 


@ 


19 


tendent and chief nurse, and shall have a black band. 
This black band upon the cap shall be the special 
designation of the rank of graduate nurse. 

The uniform for pupil nurses shall be exactly sim- 
ilar to that of graduate nurses, except that the caps 
shall be without the black band which is the badge 
of rank of the graduate nurse. 

The uniform for attendants shall be exactly similar 
to that of pupil and graduate nurses, but without cap 
of any kind. 

The uniform for male supervising nurses shall 
consist of a coat and trousers of a blue material, 
quality of goods and style of making to be agreed 
upon between the superintendent and chief nurse, 
and a vest of white material. The buttons for the 
coat shall be of brass and bear on their surface the 
word “Illinois.” The buttons for the vest shall be 
of mother-of-pearl, and removable. The shoes worn 
while on duty shall be black and always neatly pol- 
ished. © 

The uniform for male graduate nurses shall consist 
of a white duck coat of military cut, to be of ample 
proportions and neatly made; the trousers shall be 
of a dark material, closely approaching black, neatly 
cut and at all times worn supported by suspenders 
or braces. The shoes are to be black and always 
neatly polished. Male graduate nurses shall wear in 
the left lapel of the coat a button on the surface of 
which is a red cross, this to be the special designa- 
tion of the rank of graduate nurse. 

A male charge nurse of a hospital or infirmary for 
male patients, may, on the approval of the superin- 
tendent, wear a uniform exactly similar to that of 
the male supervising nurses, but shall also wear the 
red cross button in the left lapel. In the summer 
season this nurse may wear a uniform entirely of 
white, with the red cross button. 

Male pupil nurses and attendants shall wear the 
uniform described for graduate nurses, but shall not 


“be entitled to wear the red cross button. 


It shall be required that in so far as the duties of 
the service will permit, each employee in the nursing 
service shall be in full uniform during the entire 

vhours of duty. 


20 
SERVICE STRIPES. 


When a male employee shall have completed five 
years of service in the nursing force of the institu- 
tion, he shall be entitled to wear upon the left sleeve 
of his uniform coat and extending from the inner to 
the outer seam, a red stripe three-eights of an inch 
in width, material for which shall be furnished by 
the Board of Administration. For each additional 
five years of service he shall be entitled to wear an 
additional stripe in like manner on the left sleeve of 
his uniform coat. 

When a male employee shall have completed one 
year of service in the nursing force of the institution 
and presents credible evidence of service in any 
similar institution, either in America or any foreign 
country, he shall then be entitled to wear the service 
stripes indicating the total number of years he has 
served in such institutions. 

When a female employee shall have completed five 
years of service in the nursing force of the institu- 
tion, she shall be entitled to wear upon the upper 
side of the left sleeve of her uniform, a white chevron 
with a red stripe thereon, design and material of 
which shall be provided by the Board of Administra- 
tion, and each additional five years of service shall 
be indicated by an additional stripe. When the 
employee entitled to wear a chevron is a graduate 
nurse, a red cross shall also be placed upon the 
chevron. 

When a female employee shall have completed one 
year of service in the nursing force of the institution 
and presents credible evidence of service in any 
similar institution, either in America or any foreign 
country, she shall then be entitled to wear the chev- 
ron with service stripes indicating the total number 
of years she has served in such institutions. 


CHIEF NURSE. 


The engagement of the chief nurse is for service 
that is continuous. The hours of active duty shall 
be from 7:00 a. m. to 6:00 p. m. She shall be under 


the direction of the assistant superintendent, subject ~ 


to the approval of the superintendent. It shall be 


r 


¥ 


21 


her duty to take charge of the entire nursing service 
of the institution, and all the employees in this serv- 
ice are subject to her assignment. She shall assign 
the supervising nurses to an equitable division of 
the labors of supervision and require them to keep 
an accurate account of current supplies for ward 
use and of ward furnishings; and to Supervise the 
reception, marking and care of patients’ clothing; - 
and to see that no waste is permitted in any depart- 
ment of the service requiring the use of supplies. 
She shall further require a supervising nurse to be 
present at the reception of each patient and to re- 
main with and in the presence of such patient dur- 
ing the entire process of reception, including bath, 
reclothing or assigning to bed, as the case may re- 
quire; it being the intent of this rule that there 
shall be a constant and effective supervision of the 
management of patients during a period wherein 
often arises resistance on the part of the patient 
which leads to violence, to prevent the occurrence 
of unusual or unnecessary friction. 

The chief nurse shall be responsible for the carry- 
ing out the directions of the superintendent and the 
assistant superintendent concerning the housekeep- 
ing, cleanliness, sanitation and general management 
of all the wards under her care, as well as the 
general and medical care and treatment of the 
patients. She shall require all charge nurses to exe- 
cute faithfully every direction and order given them 
by the superintendent, his assistant, or any physician 
in the medical service. 

She shall be the principal of the school of instruc- 
tion for attendants and of the training school for 
nurses. 


SUPERVISING NURSES. 


' After the adoption of these rules and regulations, 
supervising nurses shall occupy the position hitherto 
Known as supervisor and supervisoress. They shall 
be graduates of a training school for nurses, of a 
hospital for the insane, or of a general hospital. , 
They shall be under the immediate control and direc- 
tion of the chief nurse, subject to the approval of 
he superintendent and assistant superintendent, and 
shall perform the duties assigned to them by the 


22 


chief nurse. Their engagement is for a service that 
is continuous, and they shall present themselves in 
uniform for duty at the rising hour each day and 
be present and in constant supervision of the depart- 
ment assigned to their care until the patients are 
seated for their morning meal. They shall spend 
practically all of their time in the department as- 
signed for their supervision, and shall fully carry out 
every direction given them by the chief nurse. — 


CHARGE NURSES. 


e 

Charge nurses shall be graduates of a training 
school for nurses, of a hospital for the insane, or 
of a general hospital. They shall, be under the im- 
mediate control and direction of the chief nurse, 
subject to the approval of the superintendent and 
his assistant, and shall perform every duty assigned 
to them by the chief nurse. Their engagement is for 
a service that is continuous, and they shall present 
themselves in uniform for duty at the rising hour 
each day. In addition to the ordinary obligation 
which a charge nurse owes the institution and its 
nursing department, charge nurses shall be held per- 
sonally responsible for the execution of every order 
of the medical department pertaining to the wards 
or patients under their charge and for the kindly 
and considerate treatment at all times of the patients 
entrusted to their care. They shall have direct 
charge, and consequent responsibility, for the condi- 
tion of cleanliness and order of their wards and of 
the patients therein and their clothing, and shall 
require helpful service and obedience from all nurses, 
pupil nurses and attendants who may be assigned 
as their assistants. 


NURSES. 


Nurses shall be graduates of a training school for, 
nurses, of a hospital for the insane, or of a general 
hospital. They shall be under the immediate control 
and direction of the chief nurse, and their assign- 
ment to place of duty may be for any length of time 
required by the chief nurse. They shall faithfully~ 
aid in all- of the work of the department to which 


23 


they may be assigned for duty and they shall be 
responsible to the charge nurse for such work as 
may be assigned them. 


Pupit NURSES. 


Pupil nurses shall be those employees of the nurs- 
ing force who have completed the course of instruc- 
tion prescribed for the school of instruction for 
attendants and are selected to take the course of 
training in the training school for nurses. They 
shall be under the immediate control and direction 
of the chief nurse, and during the course of training 
shall be subject to such detail and assignment to 
duty as the course of study or the judgment of the . 
chief nurse may require. 


ATTENDANTS. 


All employees engaged in the nursing service who 
have had institution experience, as evidenced by a 
certificate of attendance upon a course of instruction 
of a school of instruction for attendants, shall be 
assigned to duty without detail to further attendance 
upon such course of instruction. All others will be 
required to take up the course as prescribed for the 
instruction of attendants and to carry it on in such 
manner as may be prescribed by the assistant super- 
intendent and the chief nurse during the period of 
their first year of service. At the expiration of this 
period, if deemed worthy by the superintendent, they 
shall be given a certificate which shall render them 
eligible for selection to take the course in the train- 
ing school for nurses. 

All attendants shall be under the immediate direc- 
tion of the chief nurse and shall faithfully carry out 
every direction given them by supervising nurses or 
charge nurses. 


BooKLET OF INSTRUCTIONS. 


On Jan. 1, 1910, at the taking effect of this 
zy set of rules and regulations,.each employee then in 
the service, and thereafter those who enter the 


24 


service, shall receive from the superintendent, and 
give him their receipt therefor, a booklet concerning 
the conduct and relation of employees toward 
patients. This is for the special guidance and in- 
struction of those employees who are entrusted with 
the immediate care of patients and who work in any 
department with patients as helpers. All employees 
shall be held to a strict accountability for any failure 
to follow out the rules and directions therein given 
for their conduct and relations toward patients. 


THE BUSINESS ADMINISTRATION. 


The business administration shall be under the 
general direction of the chief clerk, subject in all 
things to the approval of the superintendent. The 
chief clerk is charged with the accounting of every 
nature concerning the institution’s business activi- 
ties. At the direction of the superintendent, he shall 
prepare, in the form and manner prescribed by the 
Board of Administration; the monthly estimates for 
supplies, estimates for such longer periods as may 
be required, and such special estimates as the busi- 
ness conditions of the institution may demand from 
time to time. He shall also prepare in such form 
and manner as may be prescribed from time to time 
by the Board of Administration, the necessary finan- 
cial reports, including the quarterly, annual and 
biennial reports. When the vouchers covering any 
period of business have been fully prepared, and 
approved by the superintendent, it shall be the duty 
of the chief clerk to forward both the original and 
duplicate vouchers to the fiscal supervisor of the 
board of administration in Springfield and to retain 
the triplicate vouchers in the files of the institution. 

It shall be the duty of the chief clerk and some 
other employee, to be designated by the superin- 
tendent, to make application for a commission as a 
notary public, that acknowledgments of every nature ?\ 
required in the business affairs of the institution 
may be made without charge. 

It shall be the duty of the chief clerk to require 
all clerks and stenographers except those in the , 
medical service, to perform such duties as the prompt ~ 
execution of all business transactions may require. 


25 


He shall maintain an effective supervision over the 
store, and be constantly advised of the receipt and 
disbursement of supplies of every nature, and at fre- 
quent intervals shall inspect, check and approve the 
store room accounts. He shall require of the farm 
and garden departments, together with their sub- 
departments, such reports as to farm and garden 
products used or consumed by the institution as will 
enable him to open and constantly keep a compre- 
hensive system of accounting with these departments. 
When required by the superintendent, the general 
duties of the position ordinarily known as “steward’’ 
may be assigned to him, the duties thus assigned 
from time to time to be clearly defined and set forth 
in the special order issued by the superintendent. 


THE STORE. 


The store shall be under the immediate charge 
of the storekeeper, who shall be a bonded official, 
giving such bond as may be required by the Board 
of Administration. He shall be held responsible for 
the receipt, safe-keeping and proper issue of supplies . 
of every nature. Nothing whatever shall be issued 
from the store except by requisition drawn upon the 
regular form and signed by the superintendent. He 
shall keep the store room accounts in the form and 
manner prescribed by the Board of Administration, 
and such accounts shall be kept up to the close of 
business each day, that balances of every commodity 
on hand may be quickly ascertained. He shall, at 
least once each quarter, make report to the Board of 
Administration of all supplies received and issued 
during the quarter, together with balances of com- 
modities on hand, on the forms prescribed by the 
Board of Administration. 


} THE INDUSTRIAL SERVICE. 


The system of accounting in the industrial service 
shall be under the immediate supervision of the chief 
clerk. Complete records shall be kept for each sub- 

7 department in the form and manner prescribed by 
the Board of Administration showing materials re- 
ceived and articles manufactured and delivered to 


é 


26 


the store of the institution, or to any person author- 
ized by the superintendent to sell the same; together 
with amount of loss or waste of raw materials and 


the balance of materials on hand. These depart-— 


ments will make out quarterly reports which are to 
be filed with the Board of Administration at the 
time the regular quarterly statement is filed. 

The industrial teacher shall have charge of the 
industrial employment of female patients and shall 
take up and carry out such work of manufacture, 
including fancy work and repair and mending, as 
may be required from time to time by the superin- 
tendent. 

The shop foreman shall have charge of the indus- 
trial employment of male patients. He shall be re- 
sponsible for the care and use of all materials, sup- 
plies, tools and fixtures of the shop. 


THE DOMESTIC SERVICE. 


The domestic service shall be under the imme-- 


diate direction of a chief housekeeper, with such 
assistants as may be required for the successful car- 
rying out of this work. All of the housemaids and 
dining room helpers, other than those engaged in the 
service of patients, shall be under her immediate 
charge and supervision, subject to such sub-division 
as the superintendent may from time to time direct. 
The chief housekeeper shall have special supervision 
of the laundry, and the manner of handling cloth- 
ing; especially the care of clothing against damage 
by employees or patients during the process of 
laundering; and the supervision must be kept up 
daily and reports of inefficiency, carelessness or 
neglect are to be made to the superintendent daily. 
Where institutions maintain a kitchen for the prep- 
aration of food for the officers and employees, or 
where a department of a general kitchen is set apart 


for this special service, the chief housekeeper shall? 


have charge of all its activities. She shall prepare 


bills of fare and submit them to the superintendent. 


at such times and covering such periods as he may 


from time to time require; when these have been . 


approved by the superintendent, it shall be her spe- 
cial duty to see that they are faithfully followed out. 


& 


? 


27 


THE CULINARY SERVICE. 


The culinary service shall be under. the immediate 
charge of a dietitian, who, subject to the approval 
of the superintendent, shall prepare estimates for 
food supplies and requisitions upon the store for 
their delivery to the various kitchens. The dietitian 
shall present to the superintendent, at such times as 
may be directed, a bill of fare for whatever period 
may be agreed upon and when same has been ap- 
proved by the superintendent, it shall be the duty 
of the dietitian to personally. supervise the prepara- 
tion of the food and its delivery to the various din- 
ing rooms of the institution. To this end, the dieti- 
tian shall have under immediate control all of the 
cooks, assistant cooks, and helpers in the various 
kitchens, together with the baker and his assistants, 
and the pasteurizer, and shall require all of them to 
perform such duties as may from time to time be 
delegated by the superintendent. 


THE COACHMAN. 


The coachnian shall be under the immediate direc- 
tion of the superintendent and shall have entire 
charge of the coach barn, driving horses, carriages 
and vehicles used in the driving department. Under 
the direction of the superintendent, he shall give effi- 
cient care to all of the animals in the department 
and to al] of the equipment, keeping it in a high 
state of order and repair. Where theinstitution owns .« 
an automobile for passenger or truck service, the 
coachman shall be charged with its care and man- 
agement, and shall report from time to time to the 
chief engineer any mechanical defects which require 
repair. 


AUTOMOBILES. 


’ The following order (No. 74) is hereby published 
for the guidance of officials and employees at insti- 
tutions owning and controlling automobiles: 

1. All automobiles, owned by the State charitable 
jnstitutions, under the control of this board, shall be 
‘operated exclusively for carrying on the business of 
the institutions and for the judicious use of the man- 


28 


aging officers and their families within the counties 
in which the institutions are located, but not outside 
of the counties, unless special permission is obtained 
from the Board of Administration. 

2. The managing officers of the institutions will 
be held responsible for the wear and tear of the 
automobiles and shall not permit them to be used 
excessively. They shall not be used for returning 
escaped patients. Passenger cars are not to be used 
for hauling express, baggage or freight. The chauf- 
feurs, or whoever the managing officers may place 
in immediate charge of the machines, shall keep 
a detailed record showing the amount of gasoline 
used monthly together with a detailed account of 
repairs. This record shall be open for inspection by 
any member of the Board of Administration, or rep- 
resentative thereof. 

3. The managing officers of the institutions are 
directed to deliver a copy of this order to the chauf- 
feurs, or whoever they may place in immediate 
charge of the machines, and the secretary of this 
board is directed to furnish a copy of this order to 
the State Civil Service Commission. 


THe MECHANICAL DEPARTMENT. 


The mechanical department, as set out under that 
head in these rules, shall be under the immediate 
control of the chief engineer, subject to the approval 
of the superintendent. When in his judgment, the 
service may be better carried on, the superintendent 
may trom time to time, make specia] directions for 
the carrying out of the institutions’ activities in this 
department through the heads of the various sub- 
departments under the chief engineer. The chief 
engineer shall be held responsible for the condition 
of the mechanical equipment of every nature and he 
shall be charged with the care and efficiency of oper- 
ation of the steam, water and power plants, together 
with the plumbing and electrical equipment; and 
shall maintain a constant supervision over the sewer- 
age system and have the necessary cleansing and 
flushing done at regular intervals and may be 
required by the conditions at the institution. 

It shall be his special duty to require the heac;. 
of all departments under him carefully to inspect and 
keep in as good a state of repair as may be all of the 
appliances of every nature in this department. 


of 


29 


| THE FARM DEPARTMENT. 


The farm department shall be under the immediate 

control and management of the head farmer, with his 
assistants under the direction of the superintendent, 

shal] carry out ail of the plans prescribed from time 
to time by the Board of Administration. He is 
charged with the special duty of inspection and the 
efficient operation of the dairy and the poultry depart- 
, ment, and shall have charge of all the live stock, 
vehicies and implements of every nature used in 
carrying on the farm department. Under the direc- 
tion of thé superintendent, he shall apportion the 
teams and vehicles to the garden and grounds in an 
equitable way that these departments may always be 
supplied with the necessary equipment for carrying 
on their work. 


THE GARDEN DEPARTMENT. 


The garden department shall be under the imme- 
diate supervision of the head gardner, who shall, under 
the direction of the superintendent, plan and arrange 
for the use of garden products in such a way as to 
secure the best results for the benefit of the insti- 
tution. 

When, in the judgment of the superintendent, it is 
necessary to engage the services of a florist and land- 
scape gardener, such florist shall have charge of the 
greenhouses, lawns, drives and walks, together with 
the trees, shrubs and fiowers, and the general orna- 
mentation by such agencies. Under the direction of 
the superintendent, he shall carry out all of the 
duties of this department as may be from time to 
time prescribed, and he shall perform such other 
duties as may be delegated to him by the superin- 
tendent. 


FARM AND GARDEN PRODUCTS. 


ll products of the farm or garden to be used for 
<hé consumption of the institution shall be delivered 
at whatever place may be designated by the dietitian, 
and upon their delivery a receipt in such form as 
may be prescribed by the chief clerk shall be given 
therefor, either by the dietitian or the storekeeper, 
and such receipts shall be filed with the chief clerk. 


30 


PATIENT HELP. 


The employment of patients in the various depart- 
ments of the institution service is necessary to the 
successful and economic administration of its affairs. 
The detailing of patients to the various departments 
as helpers will be at all times subject to the approval 
of the superintendent, and the requirements shal] be 
of such a nature as shall not become burdensome to 
the patient detailed to the service. It shall be kept 
constantly in mind that in employing patients in a 
helpful service, the institution has a pecuniary gain, 
but that primarily, the patient’s welfare shall have 
every consideration and the labor shall not be of 
such nature as will be burdensome or exhausting. 
The head of every department, with the sub-heads, 
who have patient labor detailed to them will be held 
strictly accountable for the care and supervision of 
patients so detailed, and for their kindly and con- 
siderate treatment, and all employees who have 
patients assisting them shall be required to work 
with the patients rather than to observe and direct 
the patient’s labor. 


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